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Vaccine . Humoral immune response following the inactivated quadrivalent influenza vaccination among HIV-infected and HIV-uninfected adults

tetano

Editor, Senior Moderator
Vaccine


. 2023 Jun 30;S0264-410X(23)00616-3.
doi: 10.1016/j.vaccine.2023.05.055. Online ahead of print. Humoral immune response following the inactivated quadrivalent influenza vaccination among HIV-infected and HIV-uninfected adults

Zhaozhen Liu[SUP] 1 [/SUP], Can Pang[SUP] 2 [/SUP], Yuchuan Deng[SUP] 3 [/SUP], Caiping Guo[SUP] 4 [/SUP], Jia Li[SUP] 5 [/SUP], Yanping Li[SUP] 6 [/SUP], Ruolei Xin[SUP] 7 [/SUP], Xiyao Li[SUP] 8 [/SUP], Conghui Xu[SUP] 9 [/SUP], Chun Huang[SUP] 10 [/SUP], Hongyan Lu[SUP] 11 [/SUP], Jie Li[SUP] 12 [/SUP]



Affiliations
Abstract

Background: A limited amount of information is available about the immunogenicity of the quadrivalent inactivated influenza vaccine among human immunodeficiency virus (HIV)-infected individuals, especially in low and middle-income countries (LMICs).
Methods: HIV-infected adults and HIV-uninfected adults received a dose of quadrivalent inactivated influenza vaccine including strains of H1N1, H3N2, BV and BY. Enzyme-linked immunosorbent assay (ELISA) and hemagglutination-inhibition assay (HAI) were used to determine IgA, IgG antibody concentration and geometric mean titers (GMT) at day 0 and day 28, respectively. Associated factors contributing to seroconversion or GMT changes were analyzed using simple logistic regression model.
Results: A total of 131 HIV-infected and 55 HIV-uninfected subjects were included in the study. In both HIV-infected and uninfected arms, IgG and IgA against influenza A and B all increased significantly at day 28 after receiving QIV (P < 0.001). GMTs of post-vaccination at day 28 showed that HIV-infected persons with CD4 + T cell counts ≤ 350 cells/mm[SUP]3[/SUP] were statistically less immunogenic to all strains of QIV than HIV-uninfected ones (P < 0.05). HIV-infected participants with CD4 + T cell counts ≤ 350 cells/mm[SUP]3[/SUP] were less likely to achieve seroconversion to QIV (H1N1, BY and BV) than HIV-uninfected individuals at day 28 after vaccination (P < 0.05). Compared with HIV-infected patients with baseline CD4 + T cell counts ≤ 350 cells/mm[SUP]3[/SUP], individuals with baseline CD4 + T cell counts > 350 cell/mm[SUP]3[/SUP] seemed more likely to generate antibody responses to H1N1 (OR:2.65, 95 %CI: 1.07-6.56) and BY (OR: 3.43, 95 %CI: 1.37-8.63), and showed a higher probability of seroconversion to BY (OR: 3.59, 95 %CI: 1.03-12.48). Compared with nadir CD4 + T cell count ≤ 350 cell/mm[SUP]3[/SUP], individuals with nadir CD4 + T cell count > 350 cell/mm[SUP]3[/SUP] showed a higher probability of seroconversion to H1N1(OR: 3.15, 95 %CI: 1.14-8.73).
Conclusion: Influenza vaccination of HIV-infected adults might be effective despite variable antibody responses. HIV-positive populations with CD4 + T cell counts ≤ 350 are less likely to achieve seroconversion. Further vaccination strategies could be developed for those with low CD4 T cell counts.

Keywords: Human immunodeficiency virus; Immunogenicity; Quadrivalent influenza vaccine; Vaccine responses.

 
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